| NPI | 1275290405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: OH 90514103) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH 90514103) |
| 101YP2500X Counselor, Professional (Licence: OH 90514103) | |
| 133N00000X Nutritionist (Licence: OH 90514103) | |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2021-11-22 |